Certificate of Capacity: Everything you need to know
Published on Posted onPlease note that this post was written for Victorian audiences and the information within may not apply to other regions.
What is a Certificate of Capacity and why do I need one?
A Certificate of Capacity is a document that is issued by a medical practitioner to an injured person in Victoria. It is issued for the purposes of claiming compensation from schemes like TAC or WorkCover.
It is used to provide information about your injury and its impact on your ability to work and undertake daily activities.
Helps your employer to understand the nature and extent of your injury and to make any necessary accommodations to help you return to work.
It also provides you with information about your injury and its impact on your ability to work. This can be useful in making decisions about your treatment and rehabilitation options.
The Certificate is also used by the relevant insurer to assess your claim and to determine the level of benefits to which you’re entitled.
How long can a Certificate of Capacity last for? How often do I need to get one?
You’ll need to get a Certificate of Capacity as soon as possible after your injury. The Certificate forms part of your claim documentation and allows the WorkCover insurer to assess your eligibility.
How often you need to obtain a Certificate of Capacity will depend on the nature of your injury and your individual circumstances.
Your first Certificate of Capacity can last for up to 14 days. Each Certificate of Capacity issued thereafter can be issued for a maximum of 28 days. If you have an injury that affects you long term, you may be able to get permission from your insurer to obtain Certificates of Capacity on a three-monthly basis.
Your medical practitioner is generally responsible for determining when you need a new Certificate based on the expected course of your injury.
If you are claiming weekly payments of compensation or loss of earnings payments from WorkCover or TAC. You need to ensure that you have a Certificate of Capacity covering any period for which you are seeking to claim payments.
The purpose of follow-up Certificates of Capacity is to provide updated information to all involved (your employer and WorkCover). Regarding your injury and its continuing impact on your ability to work and do daily tasks.
Doing so will help ensure you receive the appropriate level of support and care during your recovery.
What needs to be disclosed?
While you may feel intimidated by having to share intimate details of your health with others, the medical practitioner responsible for writing the Certificate of Capacity needs to provide detailed information about your injury.
This may include:
- The Diagnosis
- Underlying cause of your injury
- The date of your injury
- The body part affected
- The Severity of the injury
Also any complications, as well as how long you’re expected to be disabled from the injury or illness.
They also need to disclose information about your capacity for work. This includes any specific functional impairments and restrictions on your ability to perform certain tasks. Such as whether you are allowed to lift heavy items or stand for long periods.
How do I get a Certificate of Capacity?
It’s usually issued by your treating medical practitioner who has examined you and knows about your medical history.
However, it is often the case that if you have attended hospital for your injury, the hospital will issue you with your initial Certificate of Capacity.
What happens if I don’t get a Certificate of Capacity?
As mentioned earlier, you need a Certificate of Capacity to be able to make a WorkCover claim. Without one, you may have difficulty getting the benefits you’re entitled to from WorkCover.
In some cases, you may not be able to claim any benefits at all. This may leave you without the financial support you need to cover medical expenses and lost wages.
Not having a Certificate can also have consequences for your employer, including significant fines and penalties.
Can the Certificate be backdated?
In some situations, a Certificate of Capacity can be backdated. For example, you may have seen your General Practitioner at the time of your injury but not realized that you needed a Certificate of Capacity.
Certificates of Capacity can be backdated for a maximum of 90 days. However there are special reason as to why certificates can be backdated for more than 90 days.
By the way of section 167(4A) (This came into effect on September 1 2022) which states if a certificate is for a period of more than 90 days before the date that the certificate is provided, and
- The certifier states in the certificate the special reasons/information as to why the certificate relates to that period of time, and
- The WorkSafe, the Agent or Self-Insurer is satisfied with the reasons provided, the certificate can be accepted and paid on.
In most cases, you’d need to get approval from the insurer, which is often only granted in exceptional circumstances.
The best practice is for you to ensure that you are obtaining up to date Certificates of Capacity. Each Certificate provides important information and your injury and its impact on you at that particular time.
Some more blogs relevant to this topic are below:
Claiming for medical and like expenses in Victoria
Navigating the process of conciliation in Victoria
Are contractors entitled to claim WorkCover compensation in Victoria?
